Developing a Two-way SMS Platform to Prevent and Treat Wasting Among HIV-infected and HIV-exposed Uninfected Children

开发双向短信平台来预防和治疗艾滋病毒感染者和暴露于艾滋病毒的未感染儿童的消瘦

• 批准号: 10685330
• 负责人: Arianna Rubin Means
• 金额: $ 17.13万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-08-17 至 2024-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10685330
• 关键词: 2 year old; Acceleration; Address; Age; Age Months; Attitude; Behavioral; Breast Feeding; Caregivers; Caring; Cessation of life; Child; Child Care; Child Health; Childhood; Clinic; Complementary Feeding; Complex; Consumption; Cost Analysis; Developmental Delay Disorders; Diagnosis; Diet; Early identification; Education; Effectiveness; Enrollment; Exclusive Breastfeeding; Exposure to; Failure; Family; Feeds; Food; Frequencies; Grant; Guidelines; HIV; HIV Infections; HIV-exposed uninfected infant; Health Personnel; Health system; Healthcare; Healthcare Systems; Height; Home; Hospitalization; Incidence; Individual; Infant; Infection; Intention; Intervention; Iron; Kenya; Knowledge; Life; Malnutrition; Measures; Medical; Methods; Monitor; Morbidity - disease rate; Mothers; Nutritional; Nutritional Support; Opportunistic Infections; Outcome; Pathway interactions; Phase; Population; Predisposition; Prevalence; Prevention; Process; Qualifying; Quasi-experiment; Randomized; Recommendation; Recovery; Reporting; Risk; Services; Surveys; System; Techniques; Testing; Text Messaging; Time; Trust; Underweight; Upper arm; Weight; adverse outcome; arm; behavioral outcome; care seeking; care systems; caregiver education; clinical care; cost; cost effective intervention; cost effectiveness; design; dietary; effectiveness testing; empowerment; feeding; follow-up; health care availability; health care service; high risk; implementation outcomes; improved; improved outcome; incremental cost; intervention delivery; mHealth; medical complication; mortality; novel; phase III trial; prevent; programs; randomized trial; randomized, clinical trials; response; social stigma; standard of care; vaccine response; wasting

PROJECT SUMMARY/ABSTRACT Twenty-five percent of children with HIV-infection have childhood wasting (low weight-for-height or low mid-upper arm circumference, and HIV-exposed uninfected (HEU) children are twice as likely to be underweight as comparable HIV-unexposed children. Wasting is known to promote morbidity, HIV-progression, and mortality among these children. Improving wasting prevention and treatment for children and in early infant diagnosis and HIV-care programs could not only improve the child health outcomes of these children, but also substantially lower the global burden of childhood wasting. This proposal will develop a novel two-way short message service (SMS) platform that targets key barriers to improving nutritional care for HEU and HIV-infected children. This intervention will combine a maternally administered malnutrition monitoring system (MAMMS) with infant and young child education (IYCF) delivered by SMS. After developing the intervention using participatory design methods, we will complete a proof-of- concept quasi-experimental trial of MAMMS-IYCF in the R21. If the R21 milestones are meet, we will use the R33 to conduct a randomized trial testing the effectiveness of MAMMS-IYCF at reduced the incidence wasting, and the duration of wasting treatment. During this trial we will also assess the cost and cost-effectiveness of MAMMS-IYCF, and to better understand which barriers are being successfully addressed by intervention we will measure its effect on key attitudinal and behavioral outcomes including trust in the healthcare system, intention to seek if a child becomes wasted, and IYCF knowledge. This trial will generate the evidence necessary to integrate MAMMS-IYCF interventions into existing HIV-mHealth programs across the globe, and improve the outcomes of children in early infant diagnosis and HIV-care services while also substantially lowering the global burden of childhood wasting.

项目摘要/摘要 25％的艾滋病毒感染儿童患有童年浪费（低体重或中低点 手臂周长和艾滋病毒暴露的未感染（HEU）儿童体重不足的可能性是 可比的艾滋病毒无暴露儿童。已知浪费会促进发病率，艾滋病毒的产生和死亡率 在这些孩子中。改善儿童和婴儿早期诊断的预防和治疗 艾滋病毒护理计划不仅可以改善这些孩子的儿童健康成果，而且可以大大改善 降低童年浪费的全球负担。 该建议将开发一个新颖的双向短信服务（SMS）平台，该平台针对关键障碍 改善HEU和HIV感染儿童的营养护理。这种干预将与母亲结合在一起 接受婴儿和儿童教育（IYCF）的管理营养不良监测系统（MAMMS） 由短信。使用参与式设计方法进行干预后，我们将完成证明 R21中MAMMS-IYCF的概念准实验试验。如果符合R21的里程碑，我们将使用 R33进行一项随机试验，以测试妈妈-IYCF在降低发病率时的有效性， 以及浪费治疗的持续时间。在此试验中，我们还将评估 妈妈 - iycf，为了更好地理解干预成功解决哪些障碍，我们将 衡量其对关键态度和行为成果的影响，包括对医疗保健系统的信任，意图 寻找孩子是否被浪费掉，以及IYCF知识。该审判将产生必要的证据 将妈妈-IYCF干预措施整合到全球现有的HIV-MHEALTH计划中，并改善 早期婴儿诊断和艾滋病毒护理服务中儿童的结果，同时也大大降低了全球 童年浪费的负担。